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Objective: To determine how different facets of acceptance are related to quality of life (QoL) following spinal cord injury, after controlling for sociodemographic factors, injury-related variables, depression, and anxiety., Participants: Adults with spinal cord injury., Methods: Questionnaires were completed via research electronic data capture (REDCap). Three separate hierarchical multivariate linear regression analyses were performed, with physical QoL, psychological QoL, and global QoL as outcomes. Sex, age, time since injury, depression, anxiety, and 4 facets of acceptance (i.e. "accepting reality", "valuechange", "letting go of control" and "behavioural engagement") were independent variables., Results: Of the 686 eligible participants, 453 responded (66.0%). The sample included 303 men (66.9%), mean (standard deviation; SD) age 56.6 (15.0) years and mean (standard deviation) time since injury 14.6 (11.4) years. The final regression models (n = 376) explained 46% of global QoL, 47% of psychological QoL and 31% of physical QoL. The 4 facets of acceptance significantly increased the amount of variance explained by 6% for psychological QoL, 8% for physical QoL and 14% for global QoL. The facets "value-change" and "behavioural engagement" made significant contributions to all domains of QoL, while "letting go of control" only contributed to global QoL, and "accepting reality" only contributed to psychological QoL., Conclusion: Acceptance may support higher QoL in more ways than simply reducing psychological distress, and could be an important process to facilitate in rehabilitation after spinal cord injury.

Background and Purpose: In Denmark attractive rehabilitation offers for men are lacking. Consequently, more men than women say no to participate in and more often drop out of rehabilitation programs. Therefore, a nature-based rehabilitation program called the 'Wildman Programme' has been designed to men. The 'Wildman Programme' combines nature experiences, body awareness training, mind relaxation, and supporting community spirit. The method is called Nature-Body-Mind-Community (NBMC). The aim of this study was to assess the implementability and effect of the 'Wildman Programme' on the participants' quality of life and symptoms of stress., Materials and Methods: The 'Wildman Programme' was explored as a quasi-experimental study. The study included 20 men with psychological stress and diminished quality of life due to mental health challenges and chronic illnesses. The primary outcome was quality of life and the secondary outcome was stress level. All outcomes were measured at baseline (T1) and at the end of the 'Wildman Programme' (T2)., Results: The study showed the 'Wildman Programme' has potential to reduce stress symptoms (15.40%) and enhance quality of life (10.07%) among the male participants. Furthermore, physical health (13.92%) and psychological health (16.88%) in relation to quality of life increased during the program., Conclusion: The study showed that the 'Wildman Programme' is implementable in a Danish healthcare center. It was well received by the health professionals and the method was in demand by the target group of men. However, a larger study should be conducted to further investigate the findings of this study., (Copyright © 2022. Published by Elsevier Ltd.)

Men with health problems refuse to participate in rehabilitation programmes and drop out of healthcare offerings more often than women. Therefore, a nature-based rehabilitation programme was tailored specific to men with mental health problems, and long-term illnesses. The rehabilitation programme combines the use of nature, body, mind, and community spirit (NBMC) and is called the 'Wildman Programme'. The presented study was designed as a matched-control study with an intervention group participating in the Wildman Programme (N = 114) compared to a control group receiving treatment as usual (N = 39). Outcomes were measured at baseline (T1), post-intervention (T2), and 6 months post-intervention (T3). The primary outcome was the participants' quality of life measured by WHOQOL-BREF, which consists of four domains: physical health, psychological health, social relationships, and environment. The secondary outcomes were the level of stress measured by the Perceived Stress Scale (PSS), and the participants' emotional experience in relation to nature, measured by the Perceived Restorativeness Scale (PRS). The intervention group improved significantly in the physical and psychological WHOQOL-BREF domains and in PSS at both follow-ups. The participants' interest in using nature for restoration increased significantly as well. The only detectable difference between the control group and the intervention group was in the WHOQOL-BREF physical domain at the 6-month follow-up. For further studies, we recommend testing the effect of the Wildman Programme in an RCT study.

Many men have poor mental health and need help to recover. However, designing a rehabilitation intervention that appeals to men is challenging. This study protocol aims to describe the 'Wildman Programme', which will be a nature-based rehabilitation programme for men on long-term sick leave due to health problems such as stress, anxiety, depression, post-cancer and chronic cancer, chronic obstructive pulmonary disease (COPD), cardiovascular disease, or diabetes type II. The programme will be a nature-based rehabilitation initiative combining nature experiences, attention training, body awareness training, and supporting community spirit. The aim of the study will be to examine whether the 'Wildman Programme' can help to increase quality of life and reduce stress among men with health problems compared to treatment as usual. The study will be a matched control study where an intervention group (number of respondents, N = 52) participating in a 12-week nature-based intervention will be compared to a control group ( N = 52) receiving treatment as usual. Outcomes are measured at baseline (T1), post-treatment (T2), and at follow up 6 months post-intervention (T3). The results of this study will be important to state whether the method in the 'Wildman Programme' can be implemented as a rehabilitation offer in the Danish Healthcare System to help men with different health problems.

Study Design: Systematic review., Objectives: To identify, critically appraise, and synthesize research findings on the associations between acceptance, quality of life (QOL), and mental health outcomes in individuals living with spinal cord injury (SCI)., Methods: Five databases (PubMed, PsycINFO, Embase, Web of Science, and Scopus) were systematically searched. Studies were included if they provided findings on the association between acceptance and QOL, mental health outcomes, or both in an SCI population aged 16 years or older. Only peer-reviewed original quantitative and qualitative studies were included. Screening, quality assessment, and data extraction were conducted independently by two researchers. Findings were tabulated and synthesized by outcome., Results: Forty-one studies were included. Greater acceptance was consistently associated with greater global and psychological QOL, life satisfaction, sense of well-being, mental health, and with lower levels of depression and anxiety. Inconsistent evidence was found with regards to social QOL and post-traumatic stress disorder. Acceptance was generally not associated with adjustment outcomes further than 2 years into the future. Study quality of the quantitative studies was mostly fair (n = 17) followed by good (n = 13), and poor (n = 9)., Conclusion: Health-care professionals may regard acceptance as a psychological resource they can aim to support in improving QOL and mental health following SCI. A range of methodological and conceptual limitations were present in the research. Future studies should prioritize longitudinal designs, consider dyadic effects, explore subjective meaning(s) of acceptance, and investigate the effectiveness of therapeutic approaches that stimulate the acceptance process.

Chronic traumatic neck pain has a high prevalence of post-traumatic stress symptoms (PTSS). However, whether PTSS moderates treatment effects is unknown. This study investigated: 1) whether PTSS was associated with patient-reported outcomes and clinical test results at baseline; 2) whether PTSS moderated the effect of a multimodal physiotherapy intervention of exercise therapy and patient education; and 3) whether adherence to the intervention differed across PTSS groups. Secondary data analysis from a randomized controlled trial on chronic neck pain with 12-month follow-up was conducted. Patients were divided into three groups (NT = non-traumatic, LT = traumatic low PTSS, HT = traumatic high PTSS) based on self-reported onset of pain and the Impact of Event Scale. The baseline data were used to analyze the association of PTSS with patient demographics and scores of physical and mental health-related quality of life, depression, neck-related disability, kinesiophobia, and clinical tests. Baseline, 4-month and 12-month follow-up data were analyzed to investigate possible moderating effects on outcomes. Data on adherence were collected at four months. 115 participants were included (NT n = 45; LT n = 46; HT n = 24). The HT group reported lower mental health scores and more depressive symptoms at baseline. PTSS did not significantly moderate the treatment effect on any outcomes. The HT group tended to have lower adherence to the multimodal physiotherapy intervention than the LT group. For patients with traumatic neck pain, high levels of PTSS are associated with poorer psychological outcomes but do not affect the outcomes of multimodal physiotherapy intervention. [ABSTRACT FROM AUTHOR]

Background: Clinical guidelines recommend that people with back pain be given information and education about their back pain, advice to remain active and at work, and exercises to improve mobility and physical activity. Guidelines, however, rarely describe how this is best delivered. The aim of this paper is to present the development, theories, and underlying evidence for 'GLA:D Back' - a group education and exercise program that translates guideline recommendations into a clinician-delivered program for the promotion of self-management in people with persistent/recurrent back pain.Methods: GLA:D Back, which included a rationale and objectives for the program, theory and evidence for the interventions, and program materials, was developed using an iterative process. The content of patient education and exercise programs tested in randomised trials was extracted and a multidisciplinary team of expert researchers and clinicians prioritised common elements hypothesised to improve back pain beliefs and management skills. The program was tested on eight people with persistent back pain in a university clinic and 152 patients from nine primary care physiotherapy and chiropractic clinics. Following feedback from the clinicians and patients involved, the working version of the program was created.Results: Educational components included pain mechanisms, pain modulation, active coping strategies, imaging, physical activity, and exercise that emphasised a balance between the sum of demands and the individual's capacity. These were operationalised in PowerPoint presentations with supporting text to aid clinicians in delivering two one-hour patient education lectures. The exercise program included 16 supervised one-hour sessions over 8 weeks, each comprising a warm-up section and eight types of exercises for general flexibility and strengthening of six different muscle groups at four levels of difficulty. The aims of the exercises were to improve overall back fitness and, at the same time, encourage patients to explore variations in movement by incorporating education content into the exercise sessions.Conclusion: From current best evidence about prognostic factors in back pain and effective treatments for back pain, research and clinical experts developed a ready-to-use structured program - GLA:D® Back - to support self-management for people with persistent/recurrent back pain. [ABSTRACT FROM AUTHOR]